03D2258467 CLIA NUMBER - VITIELLO PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 03D2258467
  • Facility Name: VITIELLO PRIMARY CARE, PLLC
  • Facility Address: 21300 N JOHN WAYNE PKWY STE 108
    MARICOPA, AZ
    ZIP 85139
  • Facility Phone: 480 389-9419
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOANN H. VITIELLO
  • NPI Number: 1780325944
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2258467
LAB Type Practitioner Other
Facility Name VITIELLO PRIMARY CARE, PLLC
Street 21300 N JOHN WAYNE PKWY STE 108
City MARICOPA
State AZ
ZIP 85139
Phone 480 389-9419
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Practitioner Other
Lab Director JOANN H. VITIELLO

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This page was last updated on: 9/29/2025